Welcome to the monumental 97th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
- Top spot this week goes to Minh over at the awe-inspiring PHARM blog. This week’s podcast on the Emergency surgical airway – why are we reluctant? (also the SMACC CLUB entry for the “We Own The Airway” team) – with 5 experienced surgical airway practitioners is jammed packed full of pearls and pitfalls around the surgical airway and the human factors that go with. With each one of them sharing their own personal experience, making this both an extremely informative and hard hitting podcast – superb work guys!
- Actual Emergency Cricothyrotomy video – WOW awesome – that’s how its done!
- Actual Tracheostomy Video – Not an emergency case, but shows you how to do it, and Minh shares some pertinent learning points!
The LITFL Review Top Picks
- ICN Hot Case #12 – Pull my finger! – A quick quiz on aneurysms.
- Wow Oli has been busy and put together 5 Pecha Kucha on the critical care management of aneurysmal subarachnoid haemorrhage.
- Securing the Endo-tracheal Tube. One method. – Ian’s approach to securing the tube… Looks good but I wouldn’t recommend for patients at risk of high ICP.
- NSAIDs part 2: The Ceiling Effect – great post, will have you understanding what the ceiling effect is, and make sure your dosing your NSAID prescriptions correctly.>
- Left Lower Lobe Pneumonia… – with a bit of history on the symptoms of pneumonia as described by Hippocrates
- Tamiflu: A Drug Looking for an Indication. Sums it up nicely: “We need to respond quickly and decisively to combat the flu, but we need to fight the temptation to use ineffective tools simply because they are the only pharmacological options available.”
- Paediatric Arrest: But What About the Parents? – Natalie provides a thought provoking in depth look at family witnessed resuscitation in paediatric arrest. Benefits for both family and health care staff, but does need a dedicated resource for the family if its to be beneficial.
- Use of hand sanitizer can produce false-positive breathalyzer results – So are we all walking around the wards intoxicated from washing our hands?
- Be aware – Opioids can cause endocrine dysfunction
- Seizures, hyperthermia and serotonin syndrome following use of designer drug 2C-I (“Smiles”) – Not really a drug to smiling about. 2C-I (“Smiles”) is a phenethylamine that is a serotonin agonist; it is heading towards your emergency department – be prepared!
- The Thunderbox Papers: 4H’s & 4T’s. – Print it of and hang it in your resus room!
- Broome Docs Podcast: Headaches in primary care with Minh and Gerry – from the red flags through to dealing with your common, run of the mill headaches they see in GP land… The boys discuss it all.
- Clinical Case 081: Intubation Procrastination – Put yourself in a rural doc’s shoes with this case! How would you approach it?
- The new PressorDex app!! – Want to know what pressor and what rate to to give it at? There’s an app for that!
- JAMA, Integrity, Accessibility, and Social vs. Scientific Peer Review – Ryan severes it up to JAMA over their peer review process, know its our part to let them now about it! Remember there on Twitter: (@JAMA_current).
- Built a 20-person worldwide educator panel in two hours – Michelle highlights how brilliant the power of FOAM is to a bunch of medical students.
- Trick of the Trade: Use the angiocatheter for central lines . Use the angiocatheter INSTEAD of the long needle from the beginning of the procedure!
- Who Are You? – The SGEM takes on one of its supports.critics and answer some tough questions from her.
- Intubation in pre-hospital cardiac arrest strongly associated with worse outcomes (JAMA) – If you have any influence on your EMS system, we should really be advocating for simple airway adjuncts in the pre-hospital setting for cardiac arrest victims!
- Weaning from Mechanical Ventilation Update (Review, NEJM) – A quick look at strategies to reduce mechanical ventilation time.
- Back pain in the paediatric ED is definitely not as prevalent as the adult ED, but actually warrants some additional concern. Find out what those concerns are in Paediatric Back Pain!
- Traumatic cardiac arrest outcomes – There is hope in this often young, fit healthy group, and this study shows outcomes aren’t as bad as we all think they are!
- The birth of emergency medicine: Greg Henry and Don Stader – How did emergency medicine evolve into its current incarnation? Rob highlights a new documentary is on its way to show us how emergency medicine has evolved!
- Is CRP useful alone to support the hypothesis of a bacteremia? Bottom line: We can’t consider alone a normal CRP like a marker for rule out a bacteriaemia. At the same time an elevated CRP is not useful alone to prescribe antibiotic therapy.
- Blunt Trauma in a Child – and how to recognise myocardial contusion in our paediatric patients.
This week’s pearl is on cardiac screening in young athletes by Semhar Tewelde.
- Sports are associated w/an increased risk for sudden cardiac death (SCD) in athletes who are affected by cardiovascular conditions predisposing to ventricular arrhythmias (VA)
- SCD has substantially decreased in Veneto, Italy due to the introduction of a preparticipation screening program that identifies unrecognized cardiovascular conditions
- This study included 145 athletes evaluated for VA using a screening protocol of ECG, exercise testing, echocardiography, holter monitoring, and cardiac MRI
- ECG was normal in most athletes (>85%)
- VA were detected prevalently during exercise testing
- Cardiac MRI detected right ventricular regional kinetic abnormalities (ARVD) in 9 of 30 athletes
- A total of 30% of these athletes had potentially dangerous VA
- In asymptomatic athletes w/prevalently normal ECG, most VA’s can be identified by adding an exercise test
- Have you been practicing your lung ultrasound after the last episode? Have you felt that there was just something missing…..just one more piece of the puzzle?
The LITFL Review Shout Out of the Week
Shout out this week heads to Resus Review by EM physician Charles Bruen. Resus Review provides us with short sharp ‘key point’ posts on a mixture of emergency medicine and critical care topics. Check out the latest ones below:
The GMEP Cases of the week
GMEP Image of the week:
Twee Dee and Twitical Care
News from the Fastlane
- A criticism of FOAMed – what you ask? Check out The Blog Is Only As Loud As The Blogger – don’t forget to check out the comments as well for a more balance view!
- Time is nearly up…. Send Me Your SMACC CLUB Entries Now!
- We welcome back the Funtabulously Frivolous Friday Five 098 – the comeback edition.
- TechTool Thursday 019 this week reviews Critical Medical Guide by The Barringer Group – Looks like a good one, so who’s using it?
- Going to SMACC, then get the SMACC App And More!
The Final Words
LITFL Review EM/CC Educational Social Media Round Up
123Sonography.com — Academic Life in Emergency Medicine — Adventure Medicine— A Life at Risk — All LA Conference — Al Sacchetti’s Youtube — Bedside Ultrasound — Better in Emergency Medicine —boringem—Broome Docs— CCM-L.org — CLIC-EM — Critical Care Perspectives in EM — Dave on Airways —DrGDH — Dr Smith’s ECG Blog — ECG Academy — ECG Guru — ECG of the Week—ED Exam —ED-Nurse— EDTCC — EKG Videos — EM Basic — EM Core Content — EMCrit — EM CapeTown — EMDutch — Emergency Medical Abstracts —EMERJENCYWEBB –EmergencyLondon — Emergency Medicine Cases — Emergency Medicine Education — Emergency Medicine News — Emergency Medicine Ireland — Emergency Medicine Tutorials—Emergency Medicine Updates —Emergucate — emimdoc — EM Literature of Note — empem.org — EMpills — Emergency Physicians Monthly — EM Lyceum — EMProcedures — EMRAP — EMRAP: Educators’ Edition — EMRAP.TV — EM REMS — ER CAST — EXPENSIVECARE — Free Emergency Medicine Talks — GMEP — Gmergency!—Got Resuscitation— Greater Sydney Area HEMS — HQmeded.com — ICU Rounds — Impactednurse — Intensive Care Network — iTeachEM — IVLine — keepcaring — Keeping Up With Emergency Medicine — KeeWeeDoc — KI Docs — LipheLongLurnERdok — MDaware — MD+ CALC — MedEDMasters — Medical Education Videos — Medicina d’urgenza — Medicine for the Outdoors — Micrognome — Movin’ Meat — Neurointensive Care — Pediatric EM Morsels — PEM ED — PEMLit —PEMTweets Blog — PHARM — Practical Evidence — Priceless Electrical Activity — Procedurettes — PulmCCM.org — Radiology Signs — Radiopaedia — Resus.com.au — Resus.ME — Resus Review — RESUS Room — Resus Room Management — Richard Winters’ Physician Leadership —ruralflyingdoc — SCANCRIT — SCCM Blogs — SCCM Podcast — SEMEP — SinaiEM — SinaiEM Ultrasound — SMART EM — SOCMOB — SonoSpot — StEmylns — Takeokun — thebluntdissection—The Central Line — The Ember Project —The Emergency Medicine Resident Blog — The NNT — The Poison Review — The Sharp End — The Short Coat —The Skeptics Guide to Emergency Medicine — The Sono Cave – The Trauma Professional’s Blog — underneathEM.com — ToxTalk — TJdogma — Twin Cities Toxicology — Ultrarounds — UMEM Educational Pearls —Ultrasound Podcast — Ultrasound Village